Comparison of Surgery Time and Cost in Using Barbed Suture Versus the Traditional Suture in Robotic Hysterectomy: A Retrospective Cohort Study

Abstract

Determine the effect of using barbed sutures on operating room (OR) time and overall surgery cost in robotic hysterectomy. Premier Perspective Database was used to identify all inpatient hospital discharges with a robotic-assistance hysterectomy procedure (ICD-9-CM code, 68.31, 68.41, 68.61 and 17.x) between January 1, 2009 and June 30, 2010. Patients were further classified into two groups: 1) barbed suture use, 2) traditional suture group Propensity score methodology was used to match (1:1) the two groups using patient's age, race, severity of illness and hospital's region, bed size and teaching status. Inpatient discharges at US hospitals. A total of 370 patients with barbed suture use were matched with 370 patients with traditional suture use. Robotic-assistance hysterectomy. A total of 5443 hospital inpatient discharges were identified as having a robotic-assistance hysterectomy during study timeframe. Traditional suture was used in 2673 (50%) and barbed suture was used in 370 (7%) of those discharges. Discharges where LapraTy was used (5%) or when no suture use was reported (39%) were excluded from the analysis. The adjusted mean OR time was approximately 24 minutes shorter when barbed suture was used (p<.001). The mean anesthesia time was 25 minutes shorter when barbed suture was used compared to the traditional suture (p = <.001). The mean overall surgery costs were $715 less when barbed suture was used in addition to traditional suture alone ($3701 vs. $4415, respectively, p<.001). Use of a barbed suture is associated with a shorter OR and anesthesia time in patients with robotic-assistance hysterectomies, and an overall reduction in surgery costs.